| Objectives To investigate the current situation, the influence factors and the relationship between caregiver burden, coping style and quality of life of caregivers of cancer patients undergoing Chemotherapy, and evaluate the effect of therapeutic communication system on caregiver burden, coping style and quality of life of the caregivers of cancer patients undergoing Chemotherapy.Methods This research consists of two stages. The first stage is a cross-sectional survey, in this stage totally 280 primary caregivers of cancer patients from the Hospital of Anhui Medical University were were enrolled as the subjects by convenience sampling method. The self-designed general information questionnaire was used to assess the general state of the patients as well as the primary caregivers. while the Zarit Caregiver Burden Interview (ZBI) was used to assess the state of ZBI of the caregivers, the Simplified Coping Style Questionnaire was used to measure the coping style of the caregivers, the Caregiver Quality of Life Interview(CQOL) was used to measure the quality of life of the caregivers. The phase two is a experimental study. Convenience sampling method was used and totally 60 primary caregivers of cancer patients met the inclusion criteria and enrolled as our research objects.60 primary caregivers were randomly assigned to intervention or control group. The primary caregivers in the control group receiving usual care while the participants in the intervention group receiving usual care and the intervention of therapeutic communication system. This intervention consists of several times of face-to-face group and one telephone sessions. The intervention focuses on disease related information, adjustment of coping styles, communication skills with patients and other medical staff, reimbursement of medical expense. Data were collected at two time points:the first day of patients admitted to hospital (T1), and the first day of patients admitted to hospital next time (T2)Results Phase 1:(1) The total score of caregiver burden of 263 caregivers of of cancer patients undergoing chemotherapy at the baseline was (26.73±12.35), in which 65.4% experienced moderate-severe burden. The mean score of positive coping style of 263 caregivers was (1.49±0.68) and significant differences were detected between the scores of positive coping style and those in Chinese Norm(P=0.002). The mean score of negative coping style of the 263 caregivers was (1.09±0.50) and significant differences were detected between the scores of negative coping style and those in Chinese Norm (P=0.000). The baseline results showed that total score of quality of life in 263 primary caregivers of cancer patients undergoing chemotherapy were (178.43 ±43.43) and the descending order of its four dimension was physical status, spiritual status, social concerns, mental status. The multiple regressions analysis indicated that caregiver burden, negative coping style, positive coping style, care pattern, whether the patients were with complications caused by chemotherapy were the influence factors for the quality of life. (2) The baseline results revealed that caregiver burden had direct influence on quality of life(β=-0.50, P<0.05). The caregiver burden also affect quality of life through coping style in indirect effect(β=-0.25, P<0.05) and coping style partially mediates caregiver burden and quality of life.Phase 2:(1) There were no statistical differences between the general data, caregiver burden, coping style and the quality of life in the two groups before intervention (P> 0.05). (2) In the experimental group, the mean score of caregiver burden, coping style and the quality of life improved significantly (P<0.05) after intervention. (3) In the control group, the mean scores of caregiver burden, individual burden improved significantly (P<0.05) and there had no statistical significance for the rest of the variables before and after treatment. (4) There were significant melioration in the intervention group on responsibility burden, individual burden, caregiver burden, negative coping style, positive coping style, physical status, mental status, social concerns, spiritual status, quality of life after intervention compared with the control group (P<0.05).Conclusion (1) The primary caregivers of cancer patients undergoing chemotherapy suffer from caregiver burden and among them 65.4% have moderate-severe burden.(2) The main influential factors of quality of life were caregiver burden, negative coping style, positive coping style, care pattern and whether to have the chronic disease(3) Coping style partially mediates caregiver burden and quality of life. To some extent, the Therapeutic Communication System intervention which is systemic and standardized can improve the caregiver burden, coping style and the quality of life of caregivers of cancer patients undergoing chemotherapy. |
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